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Thursday, April 26, 2012

Docs are not happy: Medscape’s survey of physicians

MedScape recently surveyed over 24,000 US physicians regarding their compensation. In general, incomes are down somewhat since the 2011 survey. Most news outlets focused on the finding that only 11% of doctors considered themselves “rich,” which was not defined. Many docs pointed out that although their incomes were high, they had many expenses and debts.

Not receiving any notice were some other interesting results.

Only 54% of the respondents said that they would choose medicine as a career if they had a chance to “do it all over again.” Think about that. How sad. Anecdotally, I know a lot of unhappy doctors, but for almost half to admit that they made a poor career choice is shocking. Only 41% would choose the same specialty, and a mere 23% would practice in the same setting.

Another outcome of note is that of satisfaction by specialty. With 64% saying they were satisfied, dermatologists led the list. Specialties which had fewer than 50% of their ranks expressing satisfaction were the core groups, family medicine, internal medicine, obstetrics/gynecology and my own specialty, general surgery. Fewer than half of the general surgeons would choose medicine as a career again or general surgery as a specialty.

These findings will likely not be cited by medical schools looking to recruit applicants, who apparently don’t read surveys like this anyway. It’s not very flattering for most specialties either. How bad is it when even one-third of the dermatologists aren’t satisfied? So-called “organized medicine” will ignore all of this as they have done for years. The government will continue to put the squeeze on.

When I think of the rheumatology patient population chief complaint of pain and degeneration and then the lack of this type of patient population generally speaking in A/I, I see a probable big difference in doc satisfaction score.

I was talking to a friend at school about this. His dad is a physician who started practice in the early 70s (and was exposed to medical professional life in the late 60s). Anyway, the dad went into internal med with expectations of that world continuing to exist.

They say it no longer does. And apparently things have changed so enormously that it left a lot of the (how shall I say?) "old timers" very dissatisfied.

Point being: my friend believes this might explain the especially terrible numbers for IM. Perhaps newer docs who knew what they were getting into have greater satisfaction? Perchance.

Is this a wider phenomenon? You have lots of people who started practicing in the not-too-distant past when things were (we often hear) way better in terms of compensation, paperwork, or whatever else it is that doctors complain about. Maybe it's about managing expectations, then?

It's just so hard to fathom that so many people regret their specialty choice. As a med student, it makes the already fraught-with-terror process of residency application yet more terrifying.

That's a response rate of <10% (292,000 were polled), which I'd consider essentially worthless. This is equivalent to a reader's poll in Entertainment Weekly, it's just social media fodder and sensationalism.

And wouldn't ya know, the "lifestyle" arm of this survey paints a paradoxically rosy picture with equally awful data:

I agree that 10% is a poor rate of response, but are you aware that last year's survey showed that 69% of doctors said they would go into medicine if they could do it over?

If you are a physician or know a lot of physicians, tell me that the result of 54% is shocking to you. It's not shocking to me. Most docs I know are very unhappy. I'm surprised that 54% said they'd do it again. I would have guess much lower.

About the link to the lifestyle survey. I suppose you're going to tell me that the only responders were those who were happy with their lives outside of medicine. I don't see how the lifestyle results have any bearing on the results of the work satisfaction survey.

I for one enjoy my off hours immensely but am not happy with the many frustrations of medical practice today.

I'm aware of last years survey results, but I can't put much stock in them, either. That survey has all the same problems. Pardon my french, but "sh!t in, sh!t out."

I guess my qualm with these surveys is that Medscape is touting their data set as percentages of all doctors, which is a leap given the limitations of the survey. Let's be honest, if they wanted to run a legitimate study, they absolutely could and publish the results in a peer-reviewed journal. Those types of surveys are well-precedented but they don't generate the # of clicks and ad revenue that a iPad incentivized reader survery would.

But I agree with your sentiment (and the survey) that Docs are generally less happy and more frustrated these days. And I'd also agree that Docs are actually pretty good at enjoying their lives outside of the hospital. But I would just caution that this survey is too faulty and bias-ridden to spend much time thinking about. If we want real numbers, we should run a real study.

I agree it's not great research but it supports my personal bias, so I wrote about it.

You are right about MedScape and why they didn't publish it as a scientific paper. I have blogged about this myself. In this piece [http://is.gd/yJqmj6], I point out that far more people have read my blog than ever read any of my "scholarly" research.

This is not surprising at all. What other profession faces the level of scrutiny, threat of litigation, overall "customer" dissatisfaction, and declining revenue that MDs do. I can't think of (m)any that do, and still profess to "loving" their job.

Pres Ganey, yes those mother - farkers deserve something horrible, the bean counters love them, obsess over them and lord them over you. But if you look at the damned thing no one is ever more than one standard deviation from the mean. I have also seen the surveys sitting bedside of my severly demented nursing home patients. I would love to share the name of the miserable organisation I am working for, but it would not be right and I will be leaving soon after 4 miserable contracted years. (get it in writing what happens to your obligations if annother organisation takes over and starts unilaterally renegotiating your compensation)oh and never work for a place named after a billionare who got his fortune from shadey credit card practices!

Thanks for your comments. I think Press Ganey surveys are a joke. It's a way to meet the requirement that hospitals must survey their patients. The percentage of responses is about the same as the Medscape survey and the "science" is lacking.